Ventilatory response to CO2 in patients with snoring, obstructive hypopnoea and obstructive apnoea
Ventilatory response to CO2 in patients with snoring, obstructive hypopnoea and obstructive apnoea
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DOI：
10.1046/j.1365-2281.1997.05353.x
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发表时间：
1997-09-01
期刊：
影响因子：
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通讯作者：
Sundstrom, G
中科院分区：
文献类型：
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作者：
Appelberg, J;Sundstrom, G
阻塞性睡眠呼吸暂停(OSA)是由上呼吸道阻塞引起的。众所周知，呼吸中心对二氧化碳的足够敏感性是上呼吸道肌肉张力充足的关键因素。因此，这项研究的假设是，阻塞性睡眠呼吸暂停综合征患者对二氧化碳的呼吸反应降低。对26例鼾症患者、19例鼾症阻塞性患者和33例阻塞性呼吸暂停患者进行了研究。对照组由随机抽样的25名受试者组成，他们没有打鼾史或白天嗜睡的病史。进行了高氧和低氧对二氧化碳的呼吸反应的测试，以及静态和动态肺活量测定。OA组高氧(V-E/FetCO_2hy=12.61 min(-1)/%)、低氧(V-E/FetCO_2hy=15.7 1min-(1)/%)、低氧(V-E/FetCO_2hy=8.61min(-1)/%；V-E/FetCO_2ho=15.21min(-1)/%)、鼾症(V-E/FetCO_2hy=8.4min(-1)/%)明显高于阻塞性低通气组；V-E/FetCO2ho=12.71min(-1)/%；V-E/FetCO2hy=7.61min(-1)/%；V-E/FetCOho=9.61min(-1)/%。多元回归分析显示，颈围、呼吸暂停指数、氧减饱和指数、二氧化碳分压和性别(男性)与V-E/FetCO_2hy相关(R2=0.43)。多元回归分析还显示呼气储备容量(ERV)和性别(男性)与V-E/FetCO_2ho相关(R-2=0.21)。与这一假设相反，阻塞性睡眠呼吸暂停综合征患者表现出对二氧化碳的高氧和低氧呼吸反应增加。夜间呼吸暂停的频率和OSA中的肥胖因素可能是导致这些结果的原因。
Obstructive sleep apnoea (OSA) is caused by an obstruction of the upper airway. Sufficient sensitivity to CO2 in the respiratory centre is known to be a critical factor for adequate tone in the upper airway muscles. The hypothesis of this study is, therefore, that the ventilatory response to CO2 is reduced in patients with OSA. Twenty-six patients who suffered from snoring, 19 snoring patients with obstructive by popnoea (OH) and 33 snoring patients with obstructive apnoea (OA), were studied. The control group consisted of 25 subjects from a random sample with no history of snoring or daytime sleepiness. Tests of the hyperoxic and hypoxic ventilatory response to CO2 were performed, as well as static and dynamic spirometry. Subjects in the OA group displayed a higher hyperoxic (V-E/FetCO2hy= 12.6 1 min(-1)/%) and hypoxic (V-E/FetCO2ho = 15.7 1 min-(1)/%) ventilatory response to CO2 than patients with obstructive hypopnoea (V-E/FetCO2hy= 8.61 min(-1)/%; V-E/FetCO2ho= 15.21 min(-1)/%), snorers (V-E/FetCO2hy = 8.4 1 min(-1)/; V-E/FetCO2ho= 12.7 1 min(-1)/%) (V-E/FetCO2hy= 7.61 min(-1)/%; V-E/FetCOho= 9.61 min(-1)/%). Multiple regression analysis reveals that neck circumference, apnoea index, oxygen desaturation index, PCO2 and sex (male gender) are correlated with V-E/FetCO2hy (R-2=0.43). Multiple regression analysis also reveals that ERV (expiratory reserve volume) and sex (male gender) are correlated with V-E/FetCO2ho (R-2=0.21). Arguing against the hypothesis, patients with OSA displayed an increased hyperoxic and hypoxic ventilatory response to CO2. Nocturnal apnoea frequency and the obesity factor in OSA may have contributed to these results.